Employee Reimbursement Form - Swampscott Public Schools

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Employee Reimbursement Form
Employee Name:
School:
Date:
Account number to be charged:
Mileage @ .535¢:
Must attach mapquest directions to and from your work location.
Amount to be reimbursed:
Explanation/Purpose for expense:
Supervisor’s signature:
Business Manager’s signature:
Attach Original Receipts:
Attach Bank Statement :
(For checks, credit or debit card purchase)

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